Self-Stigma and Addiction

  • Steve MatthewsEmail author


Self-stigma in addiction occurs when individuals with substance use disorders (SUDs) experience shame based on mythological stereotypes in public stigma, as well as from their own sense of what they take to be shameful about addiction. This process leads to changes in identity in line with negative stigmatising stereotypes. The main source of the shaming process comes from public stigma where powerful others impose upon the individual with SUDs a social world (an ambience) containing false and distorting attitudes and beliefs that are internalised and lead to harmful effects, including further substance use and self-sabotage. A second source of self-stigma is the private shame that individuals feel based on accurate recognition of their situation. This may generate the motivation to heal but typically only when it occurs in a supportive context where public stigma is absent and acceptance by others is present. With the barrier of public stigma removed, or at least lowered, the individual with SUDs will stop self-stigmatising based on the damaging mythology around addiction and so may be given the support he or she needs for self-compassion, and in particular self-trust, in order to recover.


Addiction Stigma Self-stigma Shame Stereotype Human kind Acceptance Self-trust 


  1. 1.
    Ainslie G. Intertemporal bargaining in habit. Neuroethics. 2017;10:143–53.CrossRefGoogle Scholar
  2. 2.
    Andriote J-M. Don’t be angry at Spencer Cox; be angry at the stigma that pushes gay men into drugs and unsafe sex. New York: Huffpost; 2016.Google Scholar
  3. 3.
    Bayer R. Stigma and the ethics of public health: not can we but should we. Soc Sci Med. 2008;67:463–72.PubMedCrossRefGoogle Scholar
  4. 4.
    Berger PL, Luckmann T. The social construction of reality. New York: Anchor Press/Doubleday; 1966.Google Scholar
  5. 5.
    Berridge KC. Wanting and liking: observations from the neuroscience and psychology laboratory. Inquiry (Oslo). 2009;52:378.CrossRefGoogle Scholar
  6. 6.
    Braithwaite J. Crime Shame, and reintegration. Cambridge, NY: Cambridge University Press; 1989.CrossRefGoogle Scholar
  7. 7.
    Buchman D, Reiner PB. Stigma and addiction: being and becoming. Am J Bioeth Neurosci. 2009;9:18–9.CrossRefGoogle Scholar
  8. 8.
    Corrigan PW, Watson AC. The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 2002;9:35–53.CrossRefGoogle Scholar
  9. 9.
    Corrigan PW, Kuwabara SA, O’Shaughnessy J. The public stigma of mental illness and drug addiction. J Soc Work. 2009;9:139–47.CrossRefGoogle Scholar
  10. 10.
    Corrigan P, Rao D. On the self-stigma of mental illness: stages, disclosure, and strategies for change. Can J Psychiatr. 2012;57:464–9.CrossRefGoogle Scholar
  11. 11.
    Davies W. Externalist psychiatry. Analysis. 2016;76:290–6.CrossRefGoogle Scholar
  12. 12.
    Dean JC, Rud F. The drug addict and the stigma of addictions. Int J Addict. 1984;19:859–69.PubMedCrossRefGoogle Scholar
  13. 13.
    Denver M, Pickett J, Bushway SD. The language of stigmatization and the mark of violence: experimental evidence on the social construction and use of criminal record stigma. Criminology. 2017;55:664–90.CrossRefGoogle Scholar
  14. 14.
    Flanagan O. The shame of addiction. Front Psych. 2013;5(1.), Article 120):1–11.Google Scholar
  15. 15.
    Gallo KM. First person account: self-stigmatization. Schizophr Bull. 1994;20:407–10.PubMedCrossRefGoogle Scholar
  16. 16.
    Goffman E. Stigma; notes on the management of spoiled identity. Englewood Cliffs, N.J: Prentice-Hall; 1963.Google Scholar
  17. 17.
    Goldberg DS. Pain, objectivity and history: understanding pain stigma. Med Humanit. 2017;43:238–43.PubMedCrossRefGoogle Scholar
  18. 18.
    Hacking I. The looping effects of human kinds. In: Dan Sperber DP, Premack AJ, editors. Causal cognition: a multidisciplinary debate. New York: Oxford University Press; 1995. p. 351–94.Google Scholar
  19. 19.
    Hari J. Chasing the scream: the first and last days of the war on drugs. London: Bloomsbury Circus; 2015.Google Scholar
  20. 20.
    Hart C. High price. New York: Harper Collins; 2013.Google Scholar
  21. 21.
    Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health inequalities. Am J Public Health. 2013;103:813–21.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Heather N. Q: Is addiction a brain disease or a moral failing? A: neither. Neuroethics. 2017;10:115–24.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Heyman GM. Addiction: a disorder of choice. Cambridge, MA: Harvard University Press; 2009.Google Scholar
  24. 24.
    Hughes CE, Stevens A. What can we learn from the Portuguese decriminalization of illicit drugs? Br J Criminol. 2010;50:999–1022.CrossRefGoogle Scholar
  25. 25.
    Kennett J. Just say No? Addiction and the elements of self-control. In: Levy N, editor. Addiction and self-control: perspectives from philosophy, psychology, and neuroscience. Oxford: Oxford University Press; 2013. p. 144–64.CrossRefGoogle Scholar
  26. 26.
    Kennett J, Matthews S. The moral goal of treatment in cases of dual diagnosis. In: Kleinig J, Einstein S, editors. Ethical challenges for intervening in drug use: policy, research and treatment issues. Huntsville TX: OICJ Press; 2006. p. 409–36.Google Scholar
  27. 27.
    Kennett, Jeanette, Steve Matthews, and Anke Snoek. 2013. Pleasure and addiction. Front Psych 2013; 4: 117–128. doi:
  28. 28.
    Laqueur H. Uses and abuses of drug decriminalization in Portugal. Law Soc Inq. 2014;40:746–81.CrossRefGoogle Scholar
  29. 29.
    Lewis M. Memoirs of an addicted brain: a neuroscientist examines his former life on drugs. New York: Public Affairs; 2011.Google Scholar
  30. 30.
    Lewis M. The biology of desire: why addiction is not a disease. Melbourne: Scribe; 2015.Google Scholar
  31. 31.
    Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev. 1989;54:400–23.CrossRefGoogle Scholar
  32. 32.
    Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–85.CrossRefGoogle Scholar
  33. 33.
    Livingston JD, Milne T, Fang ML, Amari E. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction. 2012;107:39–50.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Luoma JB, Kohlenberg BS, Hayes SC, Bunting K, Rye AK. Reducing self-stigma in substance abuse through acceptance and commitment therapy: model, manual development, and pilot outcomes. Addict Res Theory. 2008;16:149–65.PubMedCrossRefGoogle Scholar
  35. 35.
    Luoma JB, Platt MG. Shame, self-criticism, self-stigma, and compassion in acceptance and commitment therapy. Curr Opin Psychol. 2015;2:97–101.CrossRefGoogle Scholar
  36. 36.
    MacCoun Robert J. Drugs and the law: a psychological analysis of drug prohibition. Psychol Bull. 1993;113:497–512.CrossRefGoogle Scholar
  37. 37.
    Matthews S. Anonymity and the social self. Am Philos Q. 2010;47:351–63.Google Scholar
  38. 38.
    Matthews S, Dwyer R, Snoek A. Stigma and self-stigma in addiction. J Bioeth Inq. 2017;14:275–86.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Merrill JO, Rhodes LA, Bradley KA. Mutual mistrust in the medical care of drug users. J Gen Intern Med. 2002;17:327–33.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Mittal D, Sullivan G, Chekuri L, Allee E, Corrigan PW. Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv. 2012;63:974–81.PubMedCrossRefGoogle Scholar
  41. 41.
    Patterson DL, Keefe RH. Using social construction theory as a foundation for macro-level interventions in communities impacted by HIV and addictions. J Sociol Soc Welf. 2008;35:111–26.Google Scholar
  42. 42.
    Pescosolidio BA, Tait MR, Martin JK, Long SJ. The “backbone” of stigma: identifying the global core of public prejudice associated with mental illness. Am J Public Health. 2013;103:853–60.CrossRefGoogle Scholar
  43. 43.
    Pickard H, Ahmed SH, editors. The Routledge handbook of philosophy and science of addiction. London: Routledge; 2019.Google Scholar
  44. 44.
    Pinel EC. Stigma consciousness: the psychological legacy of social stereotypes. J Pers Soc Psychol. 1999;76:114–28.PubMedCrossRefGoogle Scholar
  45. 45.
    Rodrigues S, Serper M, Novak S, Corrigan P, Hobart M. Self-stigma, self-esteem, and co-occurring disorders. J Dual Diagn. 2013;9:129–33.CrossRefGoogle Scholar
  46. 46.
    Room R. Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev. 2005;24:143–55.PubMedCrossRefGoogle Scholar
  47. 47.
    Sattler S, Escande A, Racine E, Goritz AS. Public stigma toward people with drug addiction: a factorial survey. J Stud Alcohol Drugs. 2017;78:415–25.PubMedCrossRefGoogle Scholar
  48. 48.
    Snoek A, Matthews S. Introduction: testing and refining Marc Lewis’s critique of the brain disease model of addiction. Neuroethics. 2017;10:1–6.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Tartakovsky, M. Media’s damaging depictions of mental illness. In Psych Central 2017. Accessed 11 July 2018.
  50. 50.
    Taylor S. Outside the outsiders: media representations of drug use. PRO. 2008;55:369–87.Google Scholar
  51. 51.
    Velleman JD. The genesis of shame. Philos Public Aff. 2001;30:27–52.CrossRefGoogle Scholar
  52. 52.
    Volkow ND. Preface: how science has revolutionized the understanding of drug addiction. In: Drugs, brains, and behavior: the science of addiction. Washington, DC: NIDA; 2014.Google Scholar
  53. 53.
    Williamson L, Thom B, Stimson GV, Uhl A. Stigma as a public health tool: implications for health promotion and citizen involvement. Int J Drug Policy. 2014;25:333–5.PubMedCrossRefGoogle Scholar
  54. 54.
    Wright ER, Gronfein WP, Owens TJ. Deinstitutionalization, social rejection, and the self-esteem of former mental patients. J Health Soc Behav. 2000;41:68–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Plunkett Centre for Ethics, St Vincent’s Hospital and Australian Catholic UniversityDarlinghurstAustralia

Personalised recommendations